Both Eyes on Health Care Reform in Missouri, From the Perspective of a California Transplant

Ann Marie Marciarille
Associate Professor of Law
University of Missouri--Kansas City

December 10, 2012

Teaching Law to Dental Students

Late last month, it was my privilege to spend 50 minutes talking about professional liability/dental error to an early morning crowd of senior year dental students at UMKC. I always receive far more than I give when I speak about health law to health care practitioners and learners in health care academic settings. One thing I receive is a reminder to keep it simple, keep it lively, and keep it accessible. Another thing I receive is an opportunity to look for trends in liability and quality developments peculiar to a particular medical specialty and health care group. And, finally, I gain some insight into what is on the minds of practitioners and practioners in formation around topics as diverse as tort reform, the ACA, and the changing nature of their own practices.

What did I learn at UMKC's School of Dentistry on November 29th? That no matter how early the hour or how tired the learner, practitioners are always interested in talking about liability. I am, in this regard, an ambassador from the land of the law and an introduction -- at best -- to the legal vocabulary of standard of care, negligence, causation, etc.

Motivated students learn quickly. Uniformly, students are intrigued to analyze a particular case history or treatment narrative in the way that lawyers and law students do. Lots of questions get asked. The big takeaway: although it often takes a village to commit medical error, a few providers or one institutional entity is often called upon to "take the fall." Thinking about this gives us an opportunity to think about how antiquated our tort system is, particularly in its limited capacity to conceive of system error.

I never talk about liability without also discussing quality. The dental students/learners were quite varied in their opinions on what I call the "beyond torts" question. What, if anything, might do a better job of policing dental service quality? Some thought the regulatory state would do no better, some thought courts should set the legal standard of care.

My goal is to get them thinking about the alternatives. As the fine historian Professor Bob Gross once told me: "Ann Marie, anybody can tear something down. It takes real effort to build something up."